Related Experiment Video
Updated: May 9, 2026
09:43
Epithelial Cell Repopulation and Preparation of Rodent Extracellular Matrix Scaffolds for Renal Tissue Development
Published on: August 10, 2015
Continuous renal replacement therapy in children after cardiac surgery
Maria José Santiago1, Jesús López-Herce, Javier Urbano
1Pediatric Intensive Care Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
The Journal of Thoracic and Cardiovascular Surgery
|July 23, 2013
Summary
Children needing continuous renal replacement therapy (CRRT) after heart surgery face high mortality. Hypotension upon initiating CRRT is the primary risk factor for death in these critically ill pediatric patients.
Area of Science:
- Pediatric critical care medicine
- Cardiovascular surgery
- Nephrology
Background:
- Continuous renal replacement therapy (CRRT) is used for acute kidney injury in critically ill children.
- Cardiac surgery is a significant cause of acute kidney injury in pediatric patients.
Purpose of the Study:
- To investigate the clinical outcomes of children requiring CRRT post-cardiac surgery.
- To identify factors associated with mortality in this patient population.
Main Methods:
- A prospective observational study compared children on CRRT post-cardiac surgery with other critically ill children on CRRT.
- Univariate and multivariate analyses were employed to determine mortality predictors.
Main Results:
- 4.9% of pediatric cardiac surgery patients required CRRT, with 80.2% experiencing multiorgan failure.
- CRRT patients post-cardiac surgery had lower blood pressure and renal function markers, and higher ventilation needs.
- Mortality was 43% in the cardiac surgery group versus 29% in others (P=.05).
- Hypotension at CRRT initiation was the sole independent predictor of mortality (HR 4.01).
Conclusions:
- Pediatric patients requiring CRRT after cardiac surgery have a high mortality rate.
- Hypotension is a critical, modifiable factor linked to increased mortality in these children.
Keywords:
2041ACTAKICICRRTHRPELODPICUPIMPRISMPediatric Index of MortalityPediatric Logistic Organ DysfunctionPediatric Risk of Mortality Scoreactivated clotting timeacute kidney injuryconfidence intervalcontinuous renal replacement therapyhazard ratiopediatric intensive care unitMore Related Videos
Related Concept Videos
01:30Continuous Renal Replacement Therapy
Continuous Renal Replacement Therapy, also known as CRRT, is a procedural treatment for acute kidney injury (AKI) that gradually removes uremic toxins and fluids while maintaining acid-base balance and stabilizing electrolytes. It is particularly useful for hemodynamically unstable patients. Unlike intermittent hemodialysis, which is faster, CRRT provides a gentler approach over 24 hours, closely mimicking the function of natural kidneys. However, CRRT is not ideal for patients with...
01:26Extracorporeal Removal of Drugs: Continuous Renal Replacement Therapy
Continuous Renal Replacement Therapy (CRRT) is an essential intervention for patients experiencing severe kidney dysfunction. This therapy offers a continuous mechanism for removing fluids and toxins from the bloodstream, leveraging the patient’s blood pressure to facilitate filtration through a specialized filter. This method contrasts with intermittent dialysis, providing a gentler and more consistent removal of waste products and excess fluid, which is particularly beneficial in critically...
01:26Kidney Transplant II: Surgical Procedure
Preoperative ManagementThe primary goals of preoperative management in kidney transplantation are to optimize the patient’s metabolic state and prepare them for surgery through diet adjustments, necessary dialysis, and tailored medical treatment. This phase also involves comprehensive infection screening and patient education about the surgical procedure and postoperative care to improve outcomes and adherence.Medical ManagementA comprehensive evaluation is required for both the living donor...
01:20Acute Kidney Injury V: Interprofessional Care
Acute Kidney Injury (AKI) requires a collaborative healthcare approach to restore renal function and prevent complications. Essential management strategies involve monitoring fluid and electrolyte balance, adjusting medications, initiating dialysis when necessary, and providing nutritional support.Fluid and Electrolyte ManagementFluid Monitoring: Regularly monitoring body weight, central venous pressure, and urine output helps detect fluid imbalances early. Patient intake and output are...
01:28Kidney Transplant I: Introduction
A kidney transplant is a surgical approach that involves replacing a non-functioning kidney with a healthy one from a donor. This procedure is often a treatment option for end-stage renal disease (ESRD) patients. The method requires careful recipient selection, including evaluating various medical and psychosocial factors. These criteria vary between transplant centers but generally include assessments of the patient's overall health, adherence to medical recommendations, and lifestyle...
01:16Kidney Transplant III: Nursing Management
Postoperative Nursing Management for Kidney Transplant PatientsPostoperative nursing management care includes monitoring the surgical site, encouraging early movement, and promoting lung health through breathing exercises. Nurses also administer prescribed medications like H2-blockers, such as famotidine, or proton pump inhibitors, like omeprazole, to help prevent gastrointestinal ulcers and bleeding. Fungal infections in the mouth and bladder can result from immunosuppressive and antibiotic...